The unified national social health insurance fund is administered by the National Health Insurance Agency (CNAS) and its regional centers. The following categories are insured without having to pay any contribution:

Children of 18 years and under

Individuals of 26 years and under if in higher education

War veterans/widows and invalids

Disabled people without income

Pregnant women and those who have recently given birth, if they do not earn income or their income is lower than the national gross minimum wage.

Everyone else pays contributions out of their salary. All those insured are entitled to free medical services such as medical consultations, prescriptions, and basic hospital care.

Health care in Romania is organized in two different systems.

The public system which is financed mainly through social health insurance contributions which are mandatory, with some exemptions for children, students, the unemployed and low income persons. The National Health Insurance House (CNAS) administers all the funding and is responsible for planning and purchasing , through its county branches, health services from both public and private hospitals, laboratories, pharmacies, ambulatory care specialists, GPs etc.

A smaller private system where patients have to pay for each health service they request. Private health services are used only by a small percentage of the population, as most use the public system services, which are free of charge at the point of delivery.

Romanian GPs have a gatekeeper role for the public system (CNAS). This means that those benefiting from free services can’t access any other service unless they are seen first by their GP. Patients who choose the private system don’t need to see a GP first, as they can access any service through direct payment. Government subsidized prescriptions are available only in the public system and there is a co-pay of 10-80%.

Most patients in Romania are registered with a GP of their choice. Most choose a GP close to home and don’t change the GP for many years. However, patients can change GPs after a 6 month minimum period.

2. Emergency care

Emergency services are paid from the state budget. The NHIF (National Health Insurance House) reimburses only a certain number of home visits for non-critical emergencies and ambulance transportation costs. At the hospital level, emergency care is provided in hospital emergency units that employ doctors specialized in emergency or intensive care. These are independent units within the hospital, financed from the state budget. They can be accessed directly through self-referral or by ambulance. Patients are triaged according to urgency. After receiving care at the emergency unit, patients are either admitted for further treatment in the same hospital, refereed to another hospital of higher competency, if required, or discharged.

A complimentary emergency service is available in Romania and is called SMURD (Serviciul Mobil de Urgenţǎ, Reanimare şi Descarcerare), which translates to Mobile Emergency Service for Resuscitation and Extrication. It deals with serious emergencies and can be reached by dialing 112.

Primary care is provided by family medicine physicians, GP’s, under contracts with the DHIHs (district health insurance house). Patients often rely on ambulance services and/or hospital emergency departments if they need medical assistance, including non-urgent care and within regular office hours.

Preventive medical care, such as: immunization, monitoring pregnant and women who have recently given birth, preventing the risk of illness for diagnosed medical conditions, active medical monitoring for average-risk or high-risk asymptomatic adults and children, according to age and gender. . Provision of services

Specialized ambulatory care is provided through a network of hospital outpatient departments and polyclinics, specialized medical centres, centres for diagnosis and treatment, and individual specialist physician offices under contract with the DHIHs (district health insurance house).

Inpatient care is provided by a large hospital network, with hospitals varying in terms of size or competencies. Day care is provided in hospitals and health care centres under contract with the DHIHs (district health insurance house). The most frequent health care services provided on a day care basis in Romania include hypertensionand diabetes monitoring, radiotherapy, monitoring of HIV/AIDS patients and endoscopy.

Refugees, asylum-seekers and immigrants

Since 2001, a Migrant Health Department at the International Office for Migration (IOM) Romania has provided health assessments for transiting refugees upon their arrival and pre-departure health assessments as required by the countries of resettlement, with the purpose of prevention and control of communicable diseases. Foreigners that have obtained a protection form in Romania and foreigners that have acquired a right of residence in Romania have the same rights to health care as Romanian citizens.

What to do in a hospital?

Hospital admission is possible in the following cases:

-emergencies (when the patient’s life is at risk)

-births

-potentially endemoepidemic diseases

You need a GP or specialist referral to be admitted in hospital in non-emergency situations.

For anticipated hospital stays, pre-registration is encouraged so that when you arrive at the hospital your registration process will be a quick check-in. If your admission is unanticipated, you will be settled into a patient room and registered. Please bring with you a photo identification card and insurance card.

For surgical procedures, registration offices (Patient registration) are conveniently located in the Surgery Centre. A registration area is also located in the Emergency Department, specifically for patients in need of emergency services.